New visiting nurse helps patients avoid emergency room

Frances Bassett values having an emergency room at North Big Horn Hospital within five miles of her home in Cowley. She suffers from a medical condition called COPD that keeps her homebound but in need of constant health monitoring in order to avoid costly visits to the hospital emergency room.

Although she makes regular visits to her doctor, it’s hard to get around with her oxygen tank in tow for those in-between visits that are sometimes so important in keeping her healthy. She is a prime example of the type of patient who will benefit most of North Big Horn Hospital’s new visiting nurse program.

Visiting nurse Diana Ballinger

To be eligible for the program under Medicare or Medicaid the patient must be homebound, under the care and periodic review of a provider at NBHH and need skilled nursing care on an intermittent basis.

Diana Ballinger is a registered nurse providing that service through the hospital. She has more than seven years of hospital experience. Ballinger started her career at NBHH as a receptionist and eventually got her nursing degree from Northwest College and has been a nurse for three years.

The visiting nurse service began on July 1, and Ballinger already has 10 regular patients she visits to monitor their medications, draw blood, change bandages and give injections. She also provides valuable patient education that can help those patients avoid costly hospital stays and emergency room visits through individualized preventative programs set up by the patient’s doctor.

In order to participate in the program, patients must have a referral from their doctor. Ballinger distinguished the program from existing home health programs offered through other organizations in that those programs offer the services of CNAs, as compared to the NBHH program, which only offers the services of a registered nurse.

“I have one patient I see every day to change bandages, because it’s something she can’t do for herself. I also have a couple of newly diagnosed diabetics who need education on how to administer their medication and how to monitor the changes that may require changes to their medication,” explained Ballinger. “Most of my patients right now are being monitored because of medication changes or need wound care. I have a couple of elderly patients who are having mental changes that need monitoring. The client must require skilled nursing. In other words, it must be something that only a skilled nurse is qualified to do for them. We don’t give baths or provide housekeeping services or that sort of thing like CNAs do.”

A patient’s medical care provider at NBHH must refer them in order to receive the service. Ballinger can’t accept referrals from other clinics.

“The main criteria for this service is that you can’t drive,” said Ballinger. “If you can get yourself to the hospital then you probably don’t qualify for home services. You have to be home bound. That doesn’t necessarily mean you have to stay in your home, but you have to call on either a neighbor or family member to transport you to the hospital for services because you have crutches, a walker, a scooter or you have a health issue where your doctor doesn’t want you out in public.”

Since the hospital is forced to write off visits to the hospital or emergency room that fall outside of Medicare or Medicaid guidelines, the program stands to not only benefit the bottom line on a patient’s health but the financial health of the hospital as well.

“Illnesses like pneumonia, heart failure and heart attacks can create kind of a revolving door for hospital visits,” said Ballinger. “These are the kinds of patients who benefit most from careful monitoring to make sure they don’t have to come back into the hospital again and again for treatment. For some of these patients it’s as simple as making sure they are taking their medication as prescribed and using their oxygen properly. I help them follow their doctor’s instructions and check on them to make sure they are getting better as a result of their treatments.”